• Amy Wing Wai Tse, Stephanie Ward, John J McNeil, Anna Barker, Flavia Cicuttini, Bernadette Mary Fitzgibbon, Sultana Monira Hussain, Alice Owen, Yuanyuan Wang, Rory Wolfe, and Julia Fiona-Maree Gilmartin-Thomas.
• Department of Geriatric Medicine, Prince of Wales Hospital, Randwick, New South Wales, Australia.
• Eur J Pain. 2022 Oct 1; 26 (9): 1923-1937.

BackgroundFew studies have explored the impact of low back or lower limb pain severity on recurrent (≥2) falls in older adults.ObjectivesInvestigate the association between the severity of low back or lower limb pain, and ≥2 falls or falls-related injuries.MethodsCommunity-dwelling Australian males and females in the ASPREE Longitudinal Study of Older Persons (ALSOP), aged ≥70 years. Self-reported, cross-sectional questionnaire data regarding number of falls and falls-related injuries in the last 12 months; and sites and severity of pain experienced on most days. Adjusted relative risks (RR) were estimated from multivariable Poisson regression models, for males and females separately.ResultsOf 14,892 ALSOP participants, 13% (n = 1983) reported ≥2 falls ('recurrent fallers') in the last 12 months. Males and females who reported severe low back, or severe lower limb pain on most days were more likely to report ≥2 falls in the last 12 months compared to those with mild pain (lower back: males RR = 1.70 and females RR = 1.5, p = 0.001; lower limb: males RR = 2.0, p < 0.001 and females RR = 1.4, p = 0.003). Female recurrent fallers who reported severe low back (RR = 1.3, p = 0.029) or lower limb (RR = 1.2, p = 0.024) pain on most days were more likely to report a falls-related injury in the last 12 months compared to females with mild pain.ConclusionSevere low back or lower limb pain was associated with an increased likelihood of recurrent falls (males/females) or falls-related injuries (females only). Assessment of severe low back and lower limb pain should be considered as a priority when undertaking falls-risk evaluation.SignificanceSevere low back pain, or severe lower limb pain is associated with an increased likelihood of recurrent falls in older males and females, and an increased likelihood of falls-related injuries in older female recurrent fallers. Assessment and management of severe low back and lower limb pain should be prioritized when undertaking falls-risk assessment. Future longitudinal research is required to further interrogate this relationship and its underlying mechanisms.© 2022 The Authors. European Journal of Pain published by John Wiley & Sons Ltd on behalf of European Pain Federation - EFIC ®.

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